PRENATAL DIAGNOSIS OF CONGENITAL AND HEREDITARY PATHOLOGY IN WOMEN WHO HAD COVID-19 DURING PREGNANCY

Abstract

The recent investigation of genetic and demographic processes in Ukraine has revealed an exacerbation of the demographic crisis due to a high level of reproductive losses in women that is manifested by an increased frequency of lost pregnancies and the birth of offspring being at a high risk of disability and mortality. Corona virus disease 2019 (COVID-19) caused by severe acute respiratory syndrome due to infection with the SARS-CoV-2 coronavirus spread rapidly around the world is potentially associated with complicated pregnancy. Unforeseen consequences of the COVID-19 pandemic pose a threat to the health of pregnant women. The effects of COVID-19 can be expected to become evident over years. Therefore, epidemiological information on the identification of population groups that may be at risk of severe complicated reactions is critically important. It is also essential to evaluate the situation at the different levels of population in order to outline the general directions of state policy in terms of effective countermeasures against the COVID-19 pandemic.
 Aim: to investigate the frequency and structure of congenital and hereditary pathology diagnosed by non-invasive and invasive methods of prenatal diagnosis in women who contracted COVID-19 during pregnancy.
 Material and methods. Ultrasound diagnosis of pregnant women who contracted COVID-19 during pregnancy was carried out using the Voluson E8 device and chorion biopsy in pregnant women. Collection of chorionic villi in the 1st trimester of pregnancy was carried out by aspiration method through cervical access under constant ultrasound control using a TROFOCAN catheter. An analysis of the frequency and structure of congenital and hereditary pathology was conducted based on the findings of non-invasive and invasive methods of prenatal diagnosis.
 Results. The study had demonstrated that the frequency of diagnosis of congenital foetal malformations is 6.3%. In the structure of congenital pathology, 2.5% of women had developmental anomalies of the cardiovascular system, 2.5% had congenital anomalies of the bone system, and 1.3% had multiple congenital malformations. Invasive prenatal diagnosis performed in 3.7% of women detected chromosomal pathology in 3.7% of women, and in particular, trisomy 21 of chromosomes was diagnosed in 2.5% of women, Turner syndrome was found in 1.3% of women. The frequency of chromosomal pathology in women who contracted COVID-19 during pregnancy is 3.7%. In 51 (63.7%) women who contracted COVID-19 during pregnancy, ultrasound examination of pregnant women has revealed certain features and pathological changes, especially in the structure of the placenta and changes in uteroplacental blood flow: 26.3% of women were diagnosed on premature aging of the placenta; 13.7% of women had the impairment of uteroplacental blood flow, and 23.7% of women were diagnosed as having concomitant pathology.
 Conclusion. The frequency of congenital malformations diagnosed by non-invasive prenatal diagnosis in women who contracted COVID-19 during pregnancy was 6.3%. The frequency of chromosomal pathology in the women was 3.7%. In 63.7% of women who contracted COVID-19 during pregnancy, certain features and pathological changes were detected during ultrasound examination, especially in the structure of the placenta and changes in uteroplacental blood flow.